Alternative antiretroviral therapy formulations for patients unable to swallow solid oral dosage forms

American Journal of Health-system Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists
Joan M DugganEric G Sahloff

Abstract

Evidence-based guidance is presented to assist clinicians in selecting alternative formulations of antiretroviral (ARV) agents for patients with human immunodeficiency virus (HIV) infection who are unable to swallow tablets or capsules. The inability to take medications in standard oral dosage forms can be associated with nonadherence or the use of alternative administration strategies such as capsule or tablet breaking, crushing, or chewing. Patients with HIV infection require long-term ARV therapy to maintain viral suppression; ARV agents are predominately available as tablets and capsules that may pose swallowing difficulties for some patients. Using a variety of sources (the primary literature, pharmaceutical package inserts, and requests for unpublished data from drug manufacturers), available evidence on the bioavailability of ARV medications after disruption of the capsule or tablet matrix was reviewed; information on alternative formulations of ARV agents was also assessed. With several ARV agents, disruption of the solid oral dosage form by crushing, chewing, or breaking tablets or opening capsules prior to ingestion has been shown to result in altered bioavailability or pharmacokinetics and thus the potential for inco...Continue Reading

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Citations

Jul 15, 2016·AIDS Research and Treatment·Adrienne F SchlatterRachel C Vreeman
Feb 16, 2017·Journal of the International Association of Providers of AIDS Care·Sarah Lynn Turley, Patricia Pecora Fulco
May 22, 2016·American Journal of Health-system Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists·Francesca PattiStefano Bonora
Feb 23, 2019·Journal of Clinical Pharmacy and Therapeutics·Nicole McDerbyMark Naunton
Sep 1, 2020·AACN Advanced Critical Care·Lucy Graham, Mary Beth Flynn Makic

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